Mortality trends in an ambulatory multidisciplinary heart failure unit from 2001 to 2018

Area of Science:

• Cardiology
• Clinical Research
• Public Health

Background:

• Heart failure (HF) affects millions globally, with varying outcomes based on left ventricular ejection fraction (LVEF).
• Understanding long-term mortality trends in real-world HF cohorts is crucial for clinical practice and public health initiatives.

Purpose of the Study:

• To evaluate mortality trends over 18 years (2001-2018) in ambulatory heart failure patients.
• To compare mortality trends between patients with depressed (LVEF < 50%) and preserved (LVEF ≥ 50%) left ventricular ejection fraction.

Main Methods:

• A real-life cohort of 2368 HF outpatients was analyzed.
• Patients were stratified into five quintiles based on admission period (2001-2018).
• All-cause and cardiovascular mortality rates at 1 and 3 years were assessed using linear regression, adjusting for clinical factors.

Main Results:

• Patients with LVEF < 50% showed a significant progressive decrease in 1-year and 3-year all-cause and cardiovascular mortality.
• For LVEF < 50%, 1-year mortality dropped from 12.1% to 6.5% and 3-year mortality from 30.5% to 17.0% across quintiles.
• No significant mortality trend was observed in patients with LVEF ≥ 50%.

Conclusions:

• Mortality has progressively declined in ambulatory heart failure patients with depressed LVEF over the past two decades.
• This positive trend was not observed in heart failure patients with preserved LVEF.
• Further research is needed to understand and address the static mortality rates in the preserved LVEF subgroup.